The common etiology of Activity Intolerance is related to generalized weakness and debilitation from acute or chronic illnesses. This is mostly observed in older patients with a history of orthopedic, cardiopulmonary or diabetic problems. It also results from obesity, malnourishment, anemia, and side effect medications.

Activity Intolerance is different from Fatigue.Fatigue is an extensive and subjective draining feeling not treated by rest but can also cause tiredness. Further, the goal in Activity Intolerance is to increase tolerance for and endurance of activity. In Fatigue, however, the goal is to assist the patient to adapt to fatigue, and not to increase endurance.

Related Factors

Any factors that compromise effective oxygen transport or physical conditioning or create excessive energy demands that surpass the patient’s physical and psychological abilities can cause activity intolerance. Here are some factors that may be related to Activity Intolerance:

Goals and Outcomes

The nursing goals are to reduce the effects of inactivity, promote optimal physical activity, and assist the patient with maintaining a satisfactory quality of life. The following are the common goals and expected outcomes for Activity Intolerance.

Patient will exhibit tolerance during physical activity as evidenced by a normal fluctuation of vital signs during physical activity.

Patient will identify factors that aggravate activity intolerance.

Patient will report the ability to perform required activities of daily living.

Nursing Assessment

Ongoing assessment is essential in order to identify potential problems that may have lead to Activity Intolerance as well as identify any issues that may arise during nursing care. Monitoring the individual’s responses to activity are cue points in performing an assessment related to Activity Intolerance:

Assessment

Rationales

Assess the physical activity level and mobility of the patient.

Take the resting pulse, blood pressure, and respirations.

Consider the rate, rhythm, and quality of the pulse.

If the signs are normal, have the patient perform the activity.

Obtain the vital signs immediately after activity

Have the patient rest for 3 minutes and then take the vital signs again.

Fatigue can limit the patient’s ability to perform needed activity. It can also be a medication side effect. Pay attention to the patient’s use of beta-blockers, calcium channel blockers, tranquilizers, antihistamines, relaxants, alcohol, and sedatives.

Assess the need for ambulation aids (e.g., cane, walker) for ADLs.

Assistive devices enhance the mobility of the patient by helping him overcome limitations.

Use portable pulse oximetry to assess for oxygen desaturation during activity.

May determine the use of supplemental oxygen to help compensate for the increased oxygen demands during physical activity.

Exercise maintains muscle strength, joint ROM, and exercise tolerance. Physical inactive patients need to improve functional capacity through repetitive exercises over a long period of time. Strength training is valuable in enhancing endurance of many ADLs.

Provide emotional support and positive attitude regarding abilities.

Patient may be fearful of overexertion and potential damage to the heart. Appropriate supervision during early efforts can enhance confidence.

Provide the patient with the adaptive equipment needed for completing ADLs.

Appropriate aids will enable the patient to achieve optimal independence for self-care and reduce energy consumption during activity.

Teach the patient and/or SO to recognize signs of physical overactivity or overexertion.

Knowledge promotes awareness to prevent the complication of overexertion.

Teach energy conservation techniques, such as:

Sitting to do tasks

Frequent position changes

Pushing rather than pulling

Sliding rather than lifting

Working at an even pace

Placing frequently used items within easy reach

Resting for at least 1 hour after meals before starting a new activity

Using wheeled carts for laundry, shopping, and cleaning needs

Organizing a work-rest-work schedule

These techniques reduce oxygen consumption, allowing a more prolonged activity.

For patients with pulmonary insufficiency:

Encourage conscious-controlled breathing techniques (e.g., pursed-lip breathing and diaphragmatic breathing) during increased activity and times of emotional or physical stress.

Pursed-lip breathing

Have the client breathe in through the nose, then breathe slowly out through partially closed lips while counting to seven and making a “puuu” sound.

Diaphragmatic-breathing or abdominal breathing:

Have the patient sit comfortably with knees bent and shoulders, head, neck relaxed.

Breath in slowly through the nose so that the stomach moves out against your hand.

The hand on the chest should remain as still as possible.

Place one hand in the upper chest and the other just below the rib cage to allow the palpation of the movement of the diaphragm during breathing.

Tighten the stomach muscles, letting them fall inward during exhalation through pursed-lip.

The hand on the upper chest must remain as still as possible

Helps in performing efficient breathing by maximizing the expansion of the lungs.

Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics and finding help online is near to impossible. His situation drove his passion for helping student nurses through the creation of content and lectures that is easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire students in nursing. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, breakdown complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.

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